改良微创手术治疗外伤性顽固性硬膜下积液的临床研究

Clinical Study of imporoved minimally invasive surgery for treatment of traumatic intractable subdural hematoma

目的比较改良微创硬膜下积液引流手术方法与常规微创引流手术方法的效果。方法回顾性分析两组术后1d、10d头颅CT扫描，测量两组患者硬膜下残留气体和液体量并进行统计学分析。结果改良引流组仅有微量气体和液体残留，而常规法引流组则有较多气体和液体残留，两组积气和液体残留量比较有显著统计学意义（P〈0．001）。结论改良微创硬膜下积液引流手术是治疗顽固性硬膜下积液的更好的方法，符合生理，引流彻底，手术效果好。

Objective To compare the therapeutic efficacy of improved minimally invasive surgery drainage with that of conventional minimally invasive surgery drainage in traumatic intractable subdural hematoma. Methods Fifteen patients with traumatic intractable subdural hematoma under going improved minimally invasive surgery （improved group） ,and 15 patients with traumatic intractable subdural hematoma under going conventional minimally invasive surgery drainage （conventional group）were analyzed retrospectively. The volumes of air and fluid of residual haematoma cavity on the CT scans obtained on day 1 and on day 10 postoperation in two groups were analyzed. Results Improved group had only trace residual gas and fluid. However conventional group had a large amount of subdurai air and fluid. The residual air and fluid in improved group were significantly less than those in conventional group. There was statistically significant diference in the volumes of residual air and fluid between the two groups （ P 〈 0. 001 ）. Conclusion Improved minimally invasive surgery drainage is much better than conventional drainage for traumatic intractable subdural hematoma;it conforms to physiology, drains completely, and achieres satisfactory operative effect.